MSN vs DNP: Which Should You Choose?

thinking cloud and lightbulb for decision making

If you’re looking into Nurse Practitioner school, you’ll see two different degree programs depending on which universities you’re considering. Today we’re going to talk about the similarities and differences between a Master of Science in Nursing (MSN) and a Doctor of Nursing Practice (DNP) and considerations as you choose which is best for you. 

MSN vs DNP – some common questions include:

  • Why and how the DNP came to be? 
  • What are the differences in degree completion time and the cost between MSN and DNP programs?
  • Are there differences in salary or job outlook based on which you choose?
  • What are the differences in clinical hour requirements?
  • What courses would you expect in a DNP that you wouldn’t get in the MSN? 

We’re going to answer all of these questions and more. Stick around and let’s get to it. 

First, we’ll start with a brief history to understand how these degrees came to be. 

A brief history

In the 1960s, the path to become a Nurse Practitioner involved informal continuing education courses and experiences rather than a formal university-based education. Being a RN was still considered a prerequisite to practicing as an advanced practice RN.  

In the 1980s and 1990s, the educational pathway to become a NP became university-based in the form of a MSN. Generally, MSN degrees offer at least two endpoints, most commonly a Clinical Nurse Specialist (CNS) or Nurse Practitioner. 

In 2004, the American Association of Colleges of Nursing (AACN) recommended that by 2015 all advanced practice registered nurses (APRNs) be educated with a clinical doctorate – the Doctor of Nursing Practice (DNP). The DNP would be an alternative to research-focused doctoral programs such as the PhD. 

The DNP is endorsed by the AACN as the goal for all APRNs. This lofty goal was not met by 2015 and still has not been achieved today.  So the question is – why a DNP?

There are two primary reasons for transitioning the MSN to the DNP. 

  1. Educational parity – requiring NPs to have a doctorate confers us the same educational status as many other healthcare providers. We work with other healthcare professionals who are doctorally prepared, and the AACN wants NPs to be included on this list. Our healthcare teams include doctorally-prepared physical therapists, physicians, pharmacists, doctors of osteopathy, naturopaths, and eventually, all NPs. 
  2. The need to navigate a constantly evolving and progressively more complicated health system – DNP prepared Nurse Practitioners receive additional coursework in leadership, evidence-based practice, and quality improvement. This additional coursework puts DNP prepared Nurse Practitioners in a stronger position to be leaders of positive change in healthcare. 

The MSN remains the most common entry to a career as a Nurse Practitioner, though DNP programs are becoming more and more common. 

According to a 2019 AANP survey of Nurse Practitioners, 13.2% of all NPs reported having a DNP. As you can see, MSNs are definitely more common, but no doubt that DNP is growing in popularity. The number of DNP programs is steadily growing with 348 DNP programs in 2019 in the U.S. 

So the question is: MSN vs. DNP: which should you choose? 

Similarities – MSN vs DNP

CourseworkThe didactic content to prepare you to be safe and competent with a foundational knowledge base is the same across both degrees.  

The educational higher powers require what’s called the 3Ps to be part of the curriculum. The 3Ps = 3 separate courses covering advanced physical/health assessment, advanced physiology and pathophysiology, and advanced pharmacology. 
Clinical Job OutlookThere is no difference in the scope of practice and most jobs for APRNs do not state a preference for MSN vs DNP.
Other Career OptionsBoth degrees could help you obtain a job in healthcare leadership or administration, as university faculty or a nurse educator, in research, in public policy, or in nurse informatics. *DNP holders receive more formal coursework in these arenas and someone who has the degree may be given preference. 
Salary for Clinical APRN Positions National average in 2019 was $111,840. There appears to be no difference in pay based on which degree you have. 

Differences – MSN vs DNP

DNP – Additional Coursework Additional coursework includes: healthy policy, quality improvement, evidence-based practice, leadership, health systems and outcome evaluation 

These courses build upon what is typically taught in the MSN curriculum meaning there’s more depth of coverage in the DNP.

Why? The healthcare system is complicated and constantly changing. How we deliver health care services needs continual evaluation and improvement. DNPs are in a position to be “change agents.” 

The DNP is designed to help NPs evaluate, translate, and disseminate research findings which is the backbone of quality improvement and improving patient health outcomes. 
This additional coursework will often comprise the 1st or 3rd year and is typically separated from clinical courses. 
DNP Capstone or Project A capstone or project is included as part of all DNP programs though some MSN programs include a similar, less time intensive project. 

The capstone requires the student to apply all of the leadership, evidence-based practice and quality improvement principles learned to a real world setting through a project, usually partnering with an organization in the local community. 
Time to Complete the Degree If you already have a BSN:
MSN (full-time, in person): 1.5-2 years 
DNP (full-time, in person): 3-4 years 
Cost to Complete the Degree This is really hard to estimate, and there can be a huge range as it depends on whether the program is online, in person or a hybrid. It also depends on whether you pay in-state or out of state tuition and whether the university is private or public. 

MSN:  looking at the top 20 MSN programs across the country, the range is $35,000-$65,000
DNP: looking at the top 20 DNP programs across the country, the average cost is $60,000-$90,000
Clinical Hours MSN: at least 500 clinical hours, with a range of 500-1,000 depending on the program 
DNP: the AACN recommends a minimum of 1,000 hours for DNP-prepared APRNs

Why did I choose the DNP?

  1. Convenience: To be honest, completing my DNP was partly a choice of convenience. I did not want to move out of state. All of the programs located close to my home at the time (Seattle) only offered the DNP. I was definitely concerned about the added cost and time of the DNP, but given all but one of the programs I applied to had transitioned to the DNP, I did not have much of a choice unless I wanted to move out of state. 
  2. Alignment with the future professional standard: I came to realize the DNP was poised to become the standard educational degree of all Nurse Practitioners. By completing my DNP now, I would be aligned with the standard in the event that APRNs were ever required to hold a DNP. 
  3. More clinical hours:  I did not realize this at the time when I was deciding MSN vs DNP, but having more clinical hours is a huge deal. Now to be fair, some MSN programs offer more clinical hours than others. Regardless, more clinical hours meant that I would have more clinical experience and knowledge upon graduation. 
  4. Complete the terminal degree in one shot instead of returning to school later: Since I had already committed to the disruption graduate school causes in your life, I figured it made sense to finish the highest/terminal degree for the profession. Once practicing as an APRN, I didn’t want to be in the position of wishing I had obtained my DNP and having to decide whether or not it was worth it to return to school. 

As APRNs (regardless of MSN vs DNP), we’re well equipped to provide high-quality, evidence-based care to our patients and communities. However, I am so happy that I chose the DNP route now that I am done. Even if the job can be done well with a MSN, I’m proud that I have additional tools and knowledge to critically examine the care I provide and make changes to improve quality of care and health outcomes. Having a DNP means that we obtained the highest educational degree in our profession. A DNP is not the right choice for everyone, but I believe there are many compelling reasons to go this route if your life situation permits you to.

Summary

In summary, this is not an easy decision. You have so many factors to consider when deciding whether to pursue a MSN or a DNP. Some of you may not have an option because of availability where you live, the difference in time or cost, or personal preference. While the job outlook and scope of practice are the same for APRNs with either degree, there are some significant differences. Some of the most significant differences include the time and cost to complete the degree in addition to the number of clinical hours required. Evaluating your educational and professional goals in addition to your personal situation with regard to family and finances can help guide your decision. In the end, whatever decision you make, being an APRN is so rewarding personally and professionally.

What degree did you choose? How did you choose? Are you happy with your choice?

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5 thoughts on “MSN vs DNP: Which Should You Choose?”

  1. My sister-in-law is planning to enroll in a continuing education program for nurses next school year. I like that you said she should pursue a doctor of nursing practice (DNP) because it has more clinical hours, which means she gets to have more clinical experience and knowledge, and it’s the standard degree for Nurse Practitioners. Since her goal is to become a Nurse Practitioner someday, I’ll suggest that she obtains a DNP rather than MSN. Thanks for this!

  2. Hi Levi, I’m so glad you enjoyed the article and found it helpful! You’re right on about the number of clinical hours – it’s really a big deal as you mentioned. I wish your sister-in-law all the success as she starts her NP journey.

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